Common Mental Disorders Depression - New Zealand Doctor

Asian peoples
About 7% of the New Zealand resident population is Asian, the largest ethnic
groups being Chinese, Indian and Korean, of whom the vast majority are migrants. 38
This population group is very diverse in religion, culture, language, education and
socioeconomic situation, and few generalisations can be made. However, as a group,
Asian migrants share a range of risk factors for mental disorders, such as social
isolation, language barriers, underemployment and unemployment. 38
There is little evidence on specific ways that social and cultural factors impact on
the presentation of mental disorders in this population, but the literature notes that
for many Asians there is a strong stigma associated with mental disorders which
may delay presentation and treatment. 39 It has also been reported that somatisation
(the physical manifestation of mental distress) is more common in this population
than in Western societies. 39 Health surveys have identified that Asian patients want
better access to more user-friendly services and have identified mental health as a
priority. 38,39 The Mental Health Commission report on Asian mental health highlighted,
in particular, the high mental health needs of women and refugees within smaller
migrant communities (eg, Vietnamese, Indonesian), and of older migrants and
refugees suffering from pre-migration trauma, combined with the stress of adapting
to a new culture. 39 Refugees often have specific needs associated with the effects of
trauma and/or torture. 39-41 There is general recognition of the need for New Zealand
practitioners to develop skills in interacting with Asian patients and to increase their
awareness of how cultural factors influence the presentation and treatment of mental
disorders in this population. 38
1.3 Epidemiology of common mental disorders
Prevalence in different populations
All adults
The New Zealand Mental Health Survey, 34 undertaken between 2003 and 2004,
was a nationally representative face-to-face household survey of nearly 13,000
New Zealanders (aged 16 years and over). The survey provides prevalence data for
four groups of major mental disorders: anxiety disorders, mood disorders, substance
use disorders and eating disorders. Disorders were diagnosed using a fully-structured
diagnostic interview which generated DSM-IV ® diagnoses. The survey revealed that
mental disorders are common in New Zealand, with 40% of respondents reporting
that they had experienced a disorder at some time in their lives. A total of 21% had
experienced a disorder in the 12 months preceding the survey, of which approximately
5% were classified as serious, 9% as moderate and 7% as mild. 34 Overall, anxiety
4
Identification of Common Mental Disorders and Management of Depression in Primary Care